Advancements in the science of arthroscopic surgery have resulted in a wide range of instruments being developed facilitating improved surgical techniques. However, because arthroscopy provides only limited direct access to the portion of the anatomy being operated on, problems unique to this type surgery persist. One such problem is the manipulation of lengths of suture material.
In conventional practice, one end of a strand of suture material is threaded onto a needle which is carried by a barrel-like device provided with a plunger. The needle-carrying end of the device is inserted through an opening in the patient's body to a position proximate the tissue which is to be sutured. The plunger then is actuated to force the needle outwardly from the body. As the needle emerges through the skin, it is grasped by the surgeon and is completely withdrawn so as to render accessible the said one end of the suture material. When the procedure is repeated with the other end of the material, both ends become exposed. The paths of needle travel in the procedural steps just described are generally parallel to one another in closely spaced relationship. Consequently, when the tissue spanning the separated portions of the suture material is cut, the surgeon can knot the ends drawing the knot tightly onto the tissue to complete the suture.
The method of suturing just described has several shortcomings, a principal one being the difficulty in accurately controlling the path of needle movement when the plunger is actuated. This lack of control can result in the needle causing neurovascular damage. Additionally, when the incision is made in the tissue spanning the separated portions of the suture material, the suture itself can be severed, thereby requiring the removal of its pieces and the substitution of another strand of material.